{"id":"F2024L01697","name":"Statement of Principles concerning distal biceps brachii tendinopathy (Balance of Probabilities) (No. 4 of 2025)","slug":"statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-balance-of-probabilities-no-4-","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":442674,"registerId":"F2024L01697-fast-fetch-1775957629405","compilationNumber":null,"startDate":"2026-04-12","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"1","sectionType":"section","heading":"Statement of Principles concerning distal biceps brachii tendinopathy (Balance of Probabilities) (No. 4 of 2025)","content":"---\nmeta-content-style-type: text/css\nmeta-content-type: application/xhtml+xml; charset=utf-8\n---\n\n?xml version=\"1.0\" encoding=\"utf-8\" standalone=\"no\"?>\n\n![RMA Australian Government Coat of Arms](image.001.jpeg)\n\n \n\nStatement of Principles\n\nconcerning\n\nDISTAL BICEPS BRACHII TENDINOPATHY  (Balance of Probabilities)\n\n(No. 4 of 2025)\n\nThe Repatriation Medical Authority determines the following Statement of Principles under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n \n\nDated    17 December 2024.\n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\nProfessor Terence Campbell AM\n\nChairperson\n\nby and on behalf of\n\nThe Repatriation Medical Authority\n\n \n\n   \n\n\nContents\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Application\n\n5 Definitions\n\n6 Kind of injury, disease or death to which this Statement of Principles relates\n\n7 Basis for determining the factors\n\n8 Factors that must exist\n\n9 Relationship to service\n\n10 Factors referring to an injury or disease covered by another Statement of Principles\n\nSchedule 1 - Dictionary\n\n1 Definitions\n\n \n\n \n\n\n\n\n1.                Name\n\n\nThis is the Statement of Principles concerning distal biceps brachii tendinopathy (Balance of Probabilities) (No. 4 of 2025).\n\n1.                Commencement\n\n\n              This instrument commences on 28 January 2025.\n\n1.                Authority\n\n\nThis instrument is made under subsection 196B(3) of the Veterans' Entitlements Act 1986.\n\n1.                Application\n\n\nThis instrument applies to a claim to which section 120B of the VEA or section 339 of the Military Rehabilitation and Compensation Act 2004 applies.\n\n1.                Definitions\n\n\nThe terms defined in the Schedule 1 - Dictionary have the meaning given when used in this instrument.\n\n1.                Kind of injury, disease or death to which this Statement of Principles relates\n  1.           This Statement of Principles is about distal biceps brachii tendinopathy and death from distal biceps brachii tendinopathy.\n\n\nMeaning of distal biceps brachii tendinopathy\n\n1.           For the purposes of this Statement of Principles, distal biceps brachii tendinopathy:\n  1.           means a clinically symptomatic inflammation or degeneration of the distal biceps brachii tendon; and\n  2.           includes partial or complete tears of the distal biceps brachii tendon; and\n  3.           excludes biciptitoradial bursitis not accompanied by distal biceps brachii tendinopathy.\n\n\nNote: Distal biceps brachii tendinopathy is also known as distal biceps brachii tendonitis/tendinitis or distal biceps brachii tendonosis/tendinosis.\n\nDeath from distal biceps brachii tendinopathy\n\n1.           For the purposes of this Statement of Principles, distal biceps brachii tendinopathy, in relation to a person, includes death from a terminal event or condition that was contributed to by the person's distal biceps brachii tendinopathy.\n\n\nNote: terminal event is defined in the Schedule 1 – Dictionary.\n\n1.                Basis for determining the factors\n\n\nOn the sound medical‑scientific evidence available, the Repatriation Medical Authority is of the view that it is more probable than not that distal biceps brachii tendinopathy and death from distal biceps brachii tendinopathy can be related to relevant service rendered by veterans or members of the Forces under the VEA, or members under the MRCA.\n\nNote: MRCA, relevant service and VEA are defined in the Schedule 1 – Dictionary.\n\n1.                Factors that must exist\n\n\nAt least one of the following factors must exist before it can be said that, on the balance of probabilities, distal biceps brachii tendinopathy or death from distal biceps brachii tendinopathy is connected with the circumstances of a person's relevant service:\n\n1.           having sudden forceful extension of the elbow, during elbow flexion, on the affected side at the time of clinical onset;\n\n\nNote: Examples of activities that can cause sudden forceful extension of the elbow, during elbow flexion, include catching a heavy load with a bent arm, a fall on an outstretched hand and contact sports.\n\n1.           abusing anabolic steroids at the time of clinical onset;\n2.           inability to obtain appropriate clinical management for distal biceps brachii tendinopathy before clinical worsening.\n\n\n1.                Relationship to service\n  1.           The existence in a person of any factor referred to in section 8, must be related to the relevant service rendered by the person.\n  2.           The factor set out in subsection 8(3) applies only to material contribution to, or aggravation of, distal biceps brachii tendinopathy where the person's distal biceps brachii tendinopathy was suffered or contracted before or during (but did not arise out of) the person's relevant service.\n2.            Factors referring to an injury or disease covered by another Statement of Principles\n\n\nIn this Statement of Principles:\n\n1.           if a factor referred to in section 8 applies in relation to a person; and\n2.           that factor refers to an injury or disease in respect of which a Statement of Principles has been determined under subsection 196B(3) of the VEA;\n\n\nthen the factors in that Statement of Principles apply in accordance with the terms of that Statement of Principles as in force from time to time.\n\n \n\nSchedule 1 - Dictionary  \n\nNote:               See Section 5\n\n1               Definitions\n\nIn this instrument:\n\n                             distal biceps brachii tendinopathy—see subsection 6(2).\n\n                             MRCA means the Military Rehabilitation and Compensation Act 2004.\n\n                             relevant service means:\n\n(a)          eligible war service (other than operational service) under the VEA;\n\n(b)          defence service (other than hazardous service and British nuclear test defence service) under the VEA; or\n\n(c)          peacetime service under the MRCA.\n\nNote: MRCA and VEA are defined in the Schedule 1 - Dictionary.             \n\n                             terminal event means the proximate or ultimate cause of death and includes the following:\n\n(a)           pneumonia;\n\n(b)           respiratory failure;\n\n(c)           cardiac arrest;\n\n(d)           circulatory failure; or\n\n(e)           cessation of brain function.\n\n                             VEA means the Veterans' Entitlements Act 1986.\n\n \n\n \n","sortOrder":0}],"analysis":{"kimi_summary":{"content_quality":"ok","complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument maintains its original intended scope. It is a standard Repatriation Medical Authority Statement of Principles — a discrete, single-condition instrument created under the established framework of section 196B(3) of the VEA. It does not expand beyond determining the medical factors for establishing service connection for distal biceps brachii tendinopathy, which is precisely the function these instruments are designed to perform."},"complexity_factors":["Short, focused instrument (approximately 1,500 words) dealing with a single medical condition","Only 5 defined terms in the Dictionary (distal biceps brachii tendinopathy, MRCA, relevant service, terminal event, VEA)","Simple conditional structure: three alternative factors in section 8, with only one requiring additional temporal conditions (subsection 9(2))","Single cross-reference mechanism in section 10 allowing incorporation of other Statements of Principles by reference","No nested exceptions or complex definitional recursion — the definition of the condition in section 6 is straightforward with clear inclusions and exclusions","Minimal legislative interdependence — primarily operates under subsection 196B(3) of the Veterans' Entitlements Act 1986 with straightforward application to two principal Acts"],"plain_english_summary":"This Statement of Principles defines when distal biceps brachii tendinopathy is presumed service-related for compensation claims. It sets three alternative circumstances (sudden forceful elbow extension, anabolic steroid abuse at onset, or lack of timely treatment for a pre‑existing condition) that, if linked to service on the balance of probabilities, support entitlement.\n\nIt applies to veterans under the VEA 1986 and current/former defence members under the MRCA 2004, bringing clarity to adjudication."},"flash_summary":{"complexity_score":3,"scope_assessment":{"changed":false,"description":"This instrument clarifies and confines the medical connection rules for distal biceps brachii tendinopathy (including tears and death from related terminal events) by listing specific qualifying factors and definitions. It does not broaden entitlement categories beyond the VEA/MRCA framework; rather it specifies which clinical circumstances will, if linked to relevant service, satisfy the causation test."},"complexity_factors":["Evidentiary standard is the civil 'balance of probabilities' and a medical-scientific view is adopted (Basis for determining the factors, section 7).","Causation is constrained to a short list of required factors that must be present (section 8), which simplifies but also focuses disputes on whether those specific facts occurred.","Requirement that any listed factor be related to the person's relevant service (section 9(1)) introduces an administrative link to service records and timelines.","A special rule for aggravation/material contribution where the condition pre‑existed service (section 9(2)) requires distinguishing onset vs aggravation.","Cross‑reference to other Statements of Principles where a listed factor refers to another injury/disease (section 10) adds interactional complexity across instruments.","Definitions and exclusions (Schedule 1 and section 6) — e.g. inclusion of tears, exclusion of isolated biciptitoradial bursitis, and definition of 'terminal event' — affect scope and adjudication.","Clinical concepts such as 'clinical onset', 'appropriate clinical management' and timing of steroid 'abuse' require medical interpretation and record evidence (sections 6(2), 8(2), 8(3)).","Application is limited to claims under specified provisions of the VEA and MRCA (Application, section 4 and Schedule 1), requiring administrative coordination with those schemes."],"plain_english_summary":"This Statement of Principles sets the medical rules the Repatriation Medical Authority uses to decide, on the balance of probabilities, whether distal biceps brachii tendinopathy (including partial or complete tears) is connected with a person’s relevant service. It lists the specific events or conditions that satisfy that test (sudden forceful elbow extension during flexion, anabolic steroid abuse at clinical onset, or failure to obtain appropriate clinical management) and thus may make a claimant eligible for entitlements under the VEA or MRCA. It creates an evidentiary incentive to document clinical care and the circumstances of injury."},"flash_summary_failed":{"failed":true,"reason":"Unauthenticated. Configure AI_GATEWAY_API_KEY or use a provider module. Learn more: https://ai-sdk.dev/unauthenticated-ai-gateway","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-balance-of-probabilities-no-4-","history":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-balance-of-probabilities-no-4-/history","analysis":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-balance-of-probabilities-no-4-/analysis","conflicts":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-balance-of-probabilities-no-4-/conflicts","importantCases":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-balance-of-probabilities-no-4-/important-cases","documents":"/api/acts/statement-of-principles-concerning-distal-biceps-brachii-tendinopathy-balance-of-probabilities-no-4-/documents"}}